Optimizing the Process for Establishing the
Dietary Guidelines for Americans
THE SELECTION PROCESS
Committee to Review the Process to Update the
Dietary Guidelines for Americans
Food and Nutrition Board
Health and Medicine Division
A Consensus Study Report of
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Optimizing the process for establishing the Dietary Guidelines for Americans: The selection process. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24637.
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COMMITTEE TO REVIEW THE PROCESS TO UPDATE THE DIETARY GUIDELINES FOR AMERICANS
ROBERT M. RUSSELL (Chair), Professor Emeritus, Nutrition and Medicine, Tufts University School of Medicine, Boston, MA
JAMY ARD, Professor, Department of Epidemiology and Prevention; Co-Director, Wake Forest Baptist Health Weight Management Center, Wake Forest University Baptist Medical Center, Winston-Salem, NC
STEPHANIE A. ATKINSON, Professor, Pediatrics, McMaster University, Hamilton, ON
CAROL J. BOUSHEY, Associate Researcher, Professor, Cancer Epidemiology Program; Director, Nutrition Support Shared Resource, University of Hawaii Cancer Center, Honolulu
SUSAN M. KREBS-SMITH, Chief, Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
JOSEPH LAU, Professor Emeritus, Center for Evidence Synthesis in Health, Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI
BRUCE Y. LEE, Director, Operations Research, International Vaccine Access Center; Executive Director, Global Obesity Prevention Center; Associate Professor, International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
JOANNE R. LUPTON, Distinguished Professor Emerita, Texas A&M University, College Station
SALLY C. MORTON, Dean, College of Science, Virginia Tech, Blacksburg
NICOLAAS P. PRONK, President, HealthPartners Institute; Chief Science Officer, HealthPartners, Minneapolis, MN
SUSAN B. ROBERTS, Director, Energy Metabolism Laboratory and Professor of Nutrition, U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University; Professor of Psychiatry and Staff Member in Pediatrics, Tufts Medical School, Boston, MA
A. CATHARINE ROSS, Professor, Nutrition and Physiology; Dorothy Foehr Chair and Professor, Department of Nutritional Sciences, The Pennsylvania State University, University Park
NOTE: See Appendix D, Disclosure of Conflicts of Interest.
BARBARA O. SCHNEEMAN, Emeritus Professor of Nutrition, Department of Nutrition and Department of Food Science and Technology, University of California, Davis
MARTÍN J. SEPÚLVEDA, IBM Fellow, Retired IBM Vice President of Health Systems and Policy Research, Watson Research Laboratory, IBM Corporation, St. Augustine, FL
Health and Medicine Division Study Staff
SAMANTHA M. CHAO, Study Director
MEGHAN E. QUIRK, Senior Program Officer
ANNA BURY, Research Associate
MEREDITH J. YOUNG, Senior Program Assistant
ANN L. YAKTINE, Director, Food and Nutrition Board
This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.
We thank the following individuals for their review of this report:
DAVID B. ALLISON, University of Alabama at Birmingham
KIRSTEN BIBBINS-DOMINGO, University of California, San Francisco
NANCY F. BUTTE, Baylor College of Medicine
CHRISTINA ECONOMOS, Tufts University
PHILIP GLEASON, Mathematica Policy Research, Inc.
PETER BARTON HUTT, Covington & Burling, LLP
EILEEN KENNEDY, Tufts University
RONALD KRAUSS, Children’s Hospital Oakland Research Institute
PENNY KRIS-ETHERTON, The Pennsylvania State University
SYDNE JENNIFER NEWBERRY, RAND Corporation
CHRISTOPHER H. SCHMID, Brown University
ALISON STEIBER, Academy of Nutrition and Dietetics
PATRICK J. STOVER, Cornell University
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by DIANE F. BIRT of Iowa State University and JOHANNA T. DWYER of Tufts Medical Center. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.
Federal guidance on nutrition and diet is published every 5 years in a document called the Dietary Guidelines for Americans (DGA). This publication is intended to provide up-to-date nutrition information for the U.S. public and has become the basis for federal nutrition policies and programs. However, Congress has recently questioned whether the processes whereby this guidance is developed, interpreted, and disseminated are optimal and balanced, and now has mandated a comprehensive review of the entire process.
This Consensus Study Report is a product of a special ad hoc committee that was appointed by the National Academies of Sciences, Engineering, and Medicine (the National Academies) to review the processes for each of the following:
- How the selection process for the Dietary Guidelines Advisory Committee (DGAC) can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints;
- How the Nutrition Evidence Library (NEL) is compiled and used, including whether the NEL reviews and other systematic reviews and data analysis are conducted according to rigorous and objective scientific standards;
- How systematic reviews are conducted on long-standing DGAC recommendations, including whether scientific studies are included from scientists with a range of viewpoints; and
- How the DGA can better prevent chronic disease, ensure nutritional sufficiency for all Americans, and accommodate a range of individual factors, including age, gender, and metabolic health.
This present report is the first of two reports by this committee. This first short report reviews data and makes recommendations pertinent to question 1 (above) only: the selection process. A second report will later review data and make recommendations pertaining to questions 2–4.
Although our National Academies committee grounded its work in as much evidence as possible, there are scanty data available on how best to judge the effectiveness of a selection process for populating a committee such as the DGAC. Thus, reasoning and informed judgment were often used by our committee in making its recommendations that would serve to enhance transparency, balance, and inclusiveness—while minimizing undue influences—in the DGAC selection process. The reasoning used by our committee is fully described in Chapter 4 of this report.
The DGA is a report of national significance in that it serves as the basis for all federal nutrition policies and federal nutrition assistance programs. The scientific report of the DGAC itself provides nutritional and dietary information to the public for the intended purpose of promoting health and preventing disease. Thus, the process for getting to a final DGA report is necessarily a long, complicated, and iterative one. Our committee had to struggle in limiting the scope of our meetings to the selection process only, as the DGAC selection process itself could have implications for the rest of the processes used for updating the DGA. For example, if specific topics were to be chosen as main foci for an update to the DGA, this could influence the DGAC’s composition. The opposite could also be true—the persons selected for a DGAC might readily influence the guidelines chosen for emphasis in updating. Due to the 4-month time constraint that our committee was under for issuing our report on the selection process, several such interrelated issues could not be fully explored. These issues, however, will be more fully addressed in our second report. Nevertheless, the recommendations we make in this report should stand, regardless of any considerations encountered for answering questions 2–4 in our second report.
This committee for addressing DGAC process improvement wishes to sincerely thank the many experts who assisted us with this first report by giving presentations, written commentary, and other means. And, of course, special thanks are owed to the U.S. Department of Agriculture, the sponsor of this report, and to the staff of the Food and Nutrition Board of the Health and Medicine Division of the National Academies led by Samantha Chao. It does not need to be said that it is because of the staff that most of the work is done and the task gets completed on time.
Robert M. Russell, Chair
Committee to Review the Process to Update the Dietary Guidelines for Americans
The committee and staff would like to thank those who presented statements and presentations at the public workshops held on September 1, 2016, via WebEx, and on October 17, 2016, in Washington, DC:
Richard Black, Quadrant D Consulting
Kellie Casavale, U.S. Department of Health and Human Services (HHS)
Sheldon Greenfield, University of California, Irvine
Peter Jacobson, University of Michigan
Quyen Ngo-Metzger, Agency for Healthcare Research and Quality
Julie Obbagy, U.S. Department of Agriculture (USDA)
Eve Essery Stoody, USDA
Angela Tagtow, USDA
Walter Willett, Harvard University
We would like to thank those who provided oral and written public comment to the committee. We would also like to thank the General Services Administration for its helpful background information. In addition, there are many National Academies of Sciences, Engineering, and Medicine staff members who helped throughout the study process. The staff would like to thank Clyde Behney, Peter Blair, Mattie Cohan, Chelsea Frakes, Renee Gethers, Faye Hillman, Jim Hinchman, Sarah Kelley, Rose Marie Martinez, and Tina Ritter. Finally, we would like to thank and recognize USDA for sponsoring this study and for its helpful background information.
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